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Dmitri Nepogodiev Profile picture
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5 Nov, 5 tweets, 4 min read
The @CovidSurg Week study found surgery should be delayed ≥7 weeks following SARS-CoV-2 infection.

Frequent Qs about this finding:
1⃣Applicability to children
…-publications.onlinelibrary.wiley.com/doi/epdf/10.11…
2⃣Global applicability
…-publications.onlinelibrary.wiley.com/doi/epdf/10.11…

We've addressed these Qs in @Anaes_Journal.
We pooled 30-day postop mortality children from @CovidSurg cohort study (Feb-July 2020) & @CovidSurg Week (Oct 2020).

Periop (7 days preop to 30 days postop) SARS-CoV-2:
2⃣.8⃣% (11/393) mortality

Preop (>7 days preop) SARS-CoV-2:
0⃣% (0/97) mortality

…-publications.onlinelibrary.wiley.com/doi/epdf/10.11…
Looking at just @CovidSurg Week data

Children with SARS- CoV-2 (any timing)
Postop mortality: 0% (0/207)
Postop pulmonary complications (PPC): 0.5% (10/207).

Children who did not have SARS-CoV-2
Mortality: 0.9% (125/13,616)
PPC: 2.0% (267/13,418)

…-publications.onlinelibrary.wiley.com/doi/epdf/10.11…
Overall, children with peri-operative SARS-CoV-2 infection do not appear to be at increased risk of postoperative pulmonary complications or mortality.

Delay in surgery appears to be unnecessary for most children.

…-publications.onlinelibrary.wiley.com/doi/epdf/10.11…
Turning to the question of global applicability, we have re-analysed our data by country-income subgroup.

The same pattern of increased postoperative mortality was seen in patients operated 0-6 weeks after SARS-COV-2 infection, in both HICs & LMICs.

…-publications.onlinelibrary.wiley.com/doi/epdf/10.11…

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More from @dnepo

Dmitri Nepogodiev Profile picture
5 Nov
The Editor's Choice in today's @TheLancet is the @FalconRct.

FALCON recruited 5,788 patients across 54 hospitals in 🇧🇯🇬🇭🇮🇳🇲🇽🇳🇬🇷🇼🇿🇦

Here's the story of FALCON & its global leaders who, over past 5 years, formed strong multilateral ties & friendships.

thelancet.com/journals/lance… Image
The story of @FalconRct starts with the @GlobalSurg-2 cohort study.

Published in @TheLancetInfDis, this cohort study of 12,539 patients from 343 hospitals in 66 countries found that surgical site infection risk is greatest in low HDI countries.

thelancet.com/action/showPdf… Image
Aware of this high global burden of SSI we wanted to improve the evidence base for how to reduce SSI in low/middle income countries (LMICs).

Supported by @wellcometrust-@The_MRC-DFID, exactly 5yr ago, @GlobalSurg-2 global leads gathered in Birmingham, UK to design a global RCT! Image
Read 21 tweets
Dmitri Nepogodiev Profile picture
1 Jul
So this is an example of how Impact Factor may not always tell the full story.

Reminder - 2021 impact factor is calculated as:

Denominator: articles published in 2018-19

Numerator: citations to those denominator articles, published in 2019-21

So what's happened at IJS?
In the IJS impact factor calculation, two articles in the denominator account for 37.5% (1342/3582) of all citations.

No other articles captured in the denominator received >25 citations.

Excluding those top two articles would drop IJS IF from 6.1 to 3⃣.8⃣ (2240/588).
What's the issue with including those top two articles in IJS impact factor calculation?

Well, take a look citations to the SCARE 2018 Statement.

Web of Science currently lists 1,804 citations for SCARE 2018... of these 97.7% (1762/1804) were from IJS Publishing Group journals
Read 7 tweets
Dmitri Nepogodiev Profile picture
29 Jun
Interesting article on the future of selection for surgical training by @J_Hardie, @BrennanSurgeon & co.

They don't make the point exactly but I think we need to move from differentiating candidates based on knowledge/ tick boxes of achievement, to testing aptitude & attitudes.
Clearly someone entering ST3 surgery can be expected to have a baseline of knowledge, skills, and experience. This should form the essential criteria. But I'm not sure it is useful to differentiate based on number of hernias done or posters presented so long as a minimum met.
1. How much people have achieved to date partly reflects the opportunities they have had in previous posts and this can depend on both luck and life circumstances.

2. Purpose of the training programme is... to train people. No advantage to recruiting someone very experienced.
Read 5 tweets
Dmitri Nepogodiev Profile picture
30 May 20
It's great to see so much interest in @CovidSurg's first paper in @TheLancet.

This paper was only possible because of the enthusiasm & pooled effort of hundreds of people around the world.

@aneelbhangu & I would like to highlight some key groups

🔗thelancet.com/action/showPdf…
[1/7] Image
Firstly, the Operations Committee. They have worked long days on @CovidSurg: setting up/ running REDCap databases, maintaining communications, chasing up data queries, and many, many other tasks.

The Ops Committee range from medical students to senior surgical trainees.

[2/7] Image
The Dissemination Committee are at the heart of @CovidSurg. They are the national leaders who have spearheaded the set up of the study around the world and the dissemination of its results. They've worked tirelessly to maximise the study's impact.

🔗thelancet.com/action/showPdf…
[3/7] Image
Read 7 tweets

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